Probiotics for the Management of Liver Cirrhosis and Its Complications.

Cirrhosis is the terminal stage of various chronic liver diseases, and its decompensated stage is mainly characterized by serious complications, such as hepatic encephalopathy, ascites, spontaneous bacterial peritonitis, and gastrointestinal bleeding. Gut microbial dysbiosis is prevalent in patients with cirrhosis. Considering the bidirectional regulation of the gut-liver axis, dysbiosis is closely related to the development and progression of liver cirrhosis.

Duodenal mucosal ablation by irreversible electroporation: Modulating the gut-liver axis in metabolic steatotic liver disease.

Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), a condition that currently represents the most common cause of chronic liver disease worldwide. Within this axis, the duodenum serves not only as a site of nutrient absorption but also as a metabolic sensor capable of influencing systemic and hepatic homeostasis. We have read with great interest the recent study by Yu , investigating the effects of duodenal mucosal ablation (DMA) by irreversible electroporation in a rat model of MASLD.

Metabolic Divergence Between MASLD and Metabolic Syndrome: Distinct Clinical Phenotypes and Risk Stratification Implications.

Background And Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the leading cause of chronic liver disease worldwide. Metabolic syndrome (MetS) has traditionally been used as an indicator to define metabolic dysfunction, but it may not fully reflect the risk spectrum of MASLD, underscoring the need to better understand its clinical heterogeneity. The aim of this study was to explore phenotypic heterogeneity within MASLD, in particular its overlap and divergence from MetS to improve clinical stratification.

Non-invasive biomarkers for monitoring portal hypertension in metabolic dysfunction-associated steatotic liver disease (MASLD).

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease worldwide and a major cause of morbidity and mortality. Portal hypertension (pHTN), previously thought to occur only with cirrhosis, is now recognized in MASLD even before advanced fibrosis, due to endothelial dysfunction and increased portal pressure. This underscores the need for early, noninvasive detection and treatment.

Machine learning based CAGIB score predicts in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.

Acute gastrointestinal bleeding (AGIB) is a potentially lethal complication in cirrhosis. In this prospective international multi-center study, the performance of CAGIB score for predicting the risk of in-hospital death in 2467 cirrhotic patients with AGIB was validated. Machine learning (ML) models were established based on CAGIB components, and their area under curves (AUCs) were calculated and compared.

Outcome prediction for cholangiocarcinoma prognosis: Embracing the machine learning era.

We read with great interest the study by Huang . Cholangiocarcinoma (CC) is the second most common type of primary liver tumor worldwide. Although surgical resection remains the primary treatment for this disease, almost 50% of patients experience relapse within 2 years after surgery, which negatively affects their prognosis.

Prognostic challenges in alcoholic hepatitis: From scoring systems to clinical predictors.

In this article, we discuss the recently published article by Yang . This retrospective analysis, which was conducted at a large urban tertiary care center, focused on comparing Lille model scores at days 3 and 7 with established scoring systems and identifying critical clinical predictors, such as renal dysfunction, nutritional status, and underlying cirrhosis. Alcoholic hepatitis (AH), a severe manifestation of alcohol-related liver disease, is associated with high morbidity and mortality, necessitating accurate prognostic tools and comprehensive clinical assessments.

Open questions on how metabolic dysfunction-associated steatotic liver disease shapes the course of drug-induced liver injury.

In this article, we discuss the article recently published by Zhao . This study focused on the intersection of metabolic dysfunction-associated steatotic liver disease (MASLD) and drug-induced liver injury (DILI), two major contributors to the global burden of liver disease. By analyzing clinical characteristics, metabolic parameters, immune profiles, and liver pathology, Zhao comprehensively explored how MASLD influences the presentation, severity, and prognosis of DILI.

Changing Landscape of Liver Cirrhosis Etiologies.

Background And Aims: Liver cirrhosis is a major public health problem worldwide. In Mexico, the increased prevalence of obesity and type 2 diabetes mellitus (T2DM) has contributed to an increase in the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD). This study examines the current etiologies of cirrhosis in Mexico, highlighting regional and demographic differences.

Unraveling the Metabolic Pathways Between Metabolic-Associated Fatty Liver Disease (MAFLD) and Sarcopenia.

Metabolic-Associated Fatty Liver Disease (MAFLD) is a public health concern that is constantly expanding, with a fast-growing prevalence, and it affects about a quarter of the world's population. This condition is a significant risk factor for cardiovascular, hepatic, and oncologic diseases, such as hypertension, hepatoma, and atherosclerosis. Sarcopenia was long considered to be an aging-related syndrome, but today, it is acknowledged to be secondarily related to chronic diseases such as metabolic syndrome, cardiovascular conditions, and liver diseases, among other comorbidities associated with insulin resistance and chronic inflammation, besides inactivity and poor nutrition.

Evaluating the RESET care program: Advancing towards scalable and effective healthcare solutions for metabolic dysfunction-associated liver disease.

In this article, we discuss the recently published article by Soni . This study explores the effectiveness of a comprehensive digital health program, RESET care, which integrates personalized dietary plans, structured exercise, and cognitive behavioral therapy delivered through a mobile app equipped with Internet of Things devices such as body composition analyzers and smartwatches. Metabolic dysfunction-associated liver disease (MASLD), a global health burden affecting approximately 25% of the population, demands sustainable lifestyle modifications as its primary management strategy.

MAFLD vs. MASLD: a year in review.

Introduction: In 2023, metabolic dysfunction-associated steatotic liver disease (MASLD) was introduced following metabolic dysfunction-associated fatty liver disease (MAFLD). Both aim to address the limitations of nonalcoholic fatty liver disease (NAFLD). This review analyzes the similarities and differences between MAFLD and MASLD, focusing on their impacts on epidemiology, diagnosis, stigma, and related liver diseases.

Factors Associated With Advanced Liver Fibrosis in a Population With Type 2 Diabetes: A Multicentric Study in Mexico City.

Background And Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease, primarily due to insulin resistance and type 2 diabetes (T2D). Despite the strong link between T2D and MASLD, identifying and treating liver fibrosis in T2D patients is still poor. This study aimed to identify the factors related to advanced liver fibrosis in T2D patients.

Global Burden of Major Chronic Liver Diseases in 2021.

Background: This study utilised the Global Burden of Disease data (2010-2021) to analyse the rates and trends in point prevalence, annual incidence and years lived with disability (YLDs) for major chronic liver diseases, such as hepatitis B, hepatitis C, metabolic dysfunction-associated liver disease, cirrhosis and other chronic liver diseases.

Methods: Age-standardised rates per 100,000 population for prevalence, annual incidence and YLDs were compared across regions and countries, as well as the socio-demographic index (SDI). Trends were expressed as percentage changes (PC) and estimates were reported with uncertainty intervals (UI).

Global burden of metabolic dysfunction-associated steatotic liver disease, 2010 to 2021.

Background & Aims: This study used the Global Burden of Disease data (2010-2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries.

Methods: Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI.

Impact of metabolic-associated fatty liver disease on the cholesterol efflux capacity of high-density lipoproteins in adolescents with type 2 diabetes.

Context: Type 2 diabetes (DM2) is an emerging disease in the pediatric population. DM2 is associated with metabolic-associated fatty liver disease (MAFLD). High-density lipoproteins (HDLs) are lipoproteins that are believed to have atheroprotective properties that reduce the risk of cardiovascular disease (CVD).

Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding.

Background: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB.

Global, Regional, and National Burden of Primary Liver Cancer Attributable to Metabolic Risks: An Analysis of the Global Burden of Disease Study 1990-2021.

Introduction: The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.

Methods: The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021.

Revolutionizing the understanding of liver disease: Metabolism, function and future.

The intersection between metabolic-associated steatotic liver disease (MASLD) and chronic hepatitis B virus (HBV) infection is an emerging area of research with significant implications for public health and clinical practice. Wang 's study highlights the complexities of managing patients with concurrent MASLD and HBV. The findings revealed that patients with concurrent MASLD-HBV exhibited more severe liver inflammation and fibrosis, whereas those with HBV alone presented a better lipid profile.

Effect of fatty liver disease on liver function and fibrosis in patients with chronic hepatitis B: a cross-sectional study.

Purpose: Chronic hepatitis B (CHB) and fatty liver disease (FLD) are common chronic liver diseases, both of which can progress to advanced liver diseases with poor outcome. However, it remains controversial whether the presence of FLD aggravates the disease severity of CHB patients.

Patients And Methods: All consecutive outpatients who were diagnosed with CHB at our department between March 1, 2021 and September 30, 2023 were retrospectively screened.

Erratum: Burden of disease attributable to high body mass index: an analysis of data from the Global Burden of Disease Study 2021.

[This corrects the article DOI: 10.1016/j.eclinm.

Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15-39, 1990-2021.

Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.

Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.

Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults.

Identification and quantification of the molecular species of bilirubin BDG, BMG and UCB by LC‒MS/MS in hyperbilirubinemic human serum.

Background And Aims: Unconjugated bilirubin (UCB) is a byproduct of the heme group that indicates irregularities in the metabolism of several important biological molecules, such as hemoglobin. UCB is processed by hepatic UGT1A1, which catalyzes its conjugation to the metabolites bilirubin diglucuronide (BDG) and bilirubin monoglucuronide (BMG). The serum concentrations of BDG and BMG may indicate liver injury or dysfunction.

Non-cirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management.

Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy.

The Multifaceted Role of Bilirubin in Liver Disease: A Literature Review.

Bilirubin, the primary breakdown product of hemoproteins, particularly hemoglobin, plays a key role in the diagnosis, prognosis, and monitoring of liver diseases. In acute liver diseases, such as acute liver failure, drug-induced liver injury, and viral hepatitis, bilirubin serves as a biomarker reflecting the extent of hepatocyte loss and liver damage. Chronic liver diseases, including alcohol-related liver disease, chronic hepatitis C virus infection, metabolic dysfunction-associated fatty liver disease, and autoimmune liver diseases, are marked by persistent liver injury and inflammation.